Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease.
Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease.
复制标题
降低胆固醇对冠心病患者心肌缺血的影响。
DOI：
10.1161/01.cir.95.2.324
复制
发表时间：
1997
期刊：
影响因子：
37.8
通讯作者：
Selwyn,AP
中科院分区：
文献类型：
--
作者：
Andrews,TC;Raby,K;Barry,J;Naimi,CL;Allred,E;Ganz,P;Selwyn,AP
BackgroundCholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. This study sought to determine whether cholesterol lowering also results in a reduction of myocardial ischemia during daily life.Methods and ResultsWe enrolled 40 patients with proven coronary artery disease, total serum cholesterol between 191 and 327 mg/dL, and at least one episode of ST-segment depression on ambulatory ECG monitoring. Twenty patients were randomized to an American Heart Association Step 1 diet plus placebo (placebo group) and 20 to the same diet plus lovastatin (treatment group). Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST-segment depression, and baseline serum cholesterol levels. The treatment group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST-segment depression compared with the placebo group. ST-segment depression was completely resolved in 13 of 20 patients (65%) in the treatment group versus 2 of 20 (10%) in the placebo group. The treatment group exhibited a highly significant reduction in ischemia (P<.001). By logistic regression, treatment with diet and lovastatin was an independent predictor of ischemia resolution.ConclusionsCholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of patients.
